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Alan M. Garber, Provost of Harvard University

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Alan M. Garber, Provost of Harvard University Harvard School of Public Health | Alan M. Garber, Provost of Harvard University BETTY Good afternoon, and welcome to the Voices in Leadership series. This program focuses on the nexus of science JOHNSON: and leadership to create positive change in the world of public health. I am Betty Johnson, and I have the privilege to direct and introduce this program. Our guest today could be called a Renaissance man of academia. When he was a university freshman, he said, and I quote, "I was a reluctant and ambivalent pre-med student. But after being exposed to an economics course, I switched my major to a concentration from biochemistry to economics," end quote. This switch in plan ultimately led to a PhD in economics from Harvard, while at the same time he was earning an MD degree from Stanford. Today, Dr. Alan Garber's career combines both interests. And it is no surprise that this combination of a love for science and economics eventually landed him a role as university provost. But not as any university provost, our university provost. In a political climate in Washington, DC, where robust research funded is under threat, Dr. Alan Garber is perfectly suited to lead Harvard's efforts to ensure the research pipeline remains strong. His intellectual interests are far reaching. At Stanford, he was a fellow in both the Freeman Spogli Institute for International Studies and the Stanford Institute for Economic Policy Research. He also served as director for Stanford Center for Health Policy and Center for Primary Care and Outcomes Research at Stanford School of Medicine. Dr. Garber brings an economist's perspective to questions of health policy and focuses his own research on ways to improve health care quality, delivery, and interventions. He has authored or co-authored more than 125 articles, and edited or co-edited eight books on health policy research. The recipient of numerous academic awards, he has been elected to membership in the American Society for Clinical Investigation, the Institute of Medicine of the National Economy of Sciences, the Association of American Physicians, and a fellow of the Royal College of Physicians. And if this is not enough to keep him busy, Dr. Garber loves new technology and considers digital learning as woven into the pedagogical fabric of the university. When he isn't exploring new gadgets, he can be found in a swimming pool, where he has become quite an accomplished aqua jogger. Before I turn this session over to Dr. Bob Blendon, Senior Associate Dean for Policy Translation and Leadership Development here at the school, and who will conduct today's interview, please join me as we welcome Dr. Alan Garber to the Voices in Leadership series at the Harvard T.H. Chan School of Public Health. Thank you. [APPLAUSE] ROBERT J. Betty, thank you very much. Before we start with Dr. Garber, I always thank the students. This idea for this series BLENDON: is a student generated idea. And what was the concern? The concern was you are exposed worldwide that people who make leadership decisions, they're different than we are or talk about in our classrooms. And people wanted to know how do they think about it? How do they make the decisions? What do they draw on? Are there any lessons for this? To be quite honest, a lot of people at Harvard hope to be sitting where Dr. Garber is at somewhere in their life. So is there things and insights that we can bring? So that's what this series is, and we have tried to be responsive. So my struggle is to ask just a small number of very general questions that gets him to really talk about more broadly. So we have two stages here. One is, he did start at a section that not every physician decided to be an economist. That may have changed over the years. So tell us, Alan, how you made the decision of putting the two together and what did it look like at that time versus this time. What did you see your role in academics, in medicine, when you put the two together? ALAN M. Well, thank you, Bob. And thank you, Betty, for that very generous introduction. I think Betty gave a great GARBER: capsule explanation, but maybe I'll expand on this just a little bit. I came and, as she mentioned, started out as a biochemistry major. Biochemical sciences concentrator, as it's called at Harvard. And I took EC10, the introductory economics course which almost everybody took back then. When I say almost everybody, there were 900 other undergraduates in the class. The size of a Harvard College class at the time was around 1,600. So more than half of all the students took the course. And I discovered I loved it. But I still took a heavy science load and took this one economics course. And I thought the issues that economists were grappling with were truly compelling issues. And my second year, I moved into one of the residential houses, Dunster House, and the resident tutor in economics convinced me that if I loved economics that much, I should actually study it. That is, make it my concentration. And so he ended up convincing me to switch to economics and gave me advice, including become a research assistant for a faculty member. And I did. Dick Freeman, who's still on the faculty, a labor economist. And as time went on, I was thinking, I thought I'd probably want to become a physician. And I was still thinking that. But I got more and more deeply involved in economics, and I started taking graduate courses. And at some point, I had to make a decision about what I would do after college. And I went around and spoke to various people around Harvard. I went to some economists and said, I think I'm interested in health policy issues and would like to think about population level health and so on. And the economists said, well, you should definitely get a PhD in economics, then. It's the best set of tools. I went to physicians. People on our medical faculty said, you should definitely get an MD. That's the best way to approach it. I went to the then dean of the School of Public Health who said you should get a doctorate in public health, because it combines all these skills. ROBERT J. Perfectly logical. BLENDON: ALAN M. However, some of the faculty, I spent more time with than the others. And that's the economics faculty. I was in GARBER: their midst because I was working as a research assistant. And I thought I would probably get a PhD in economics, but I did have one nagging doubt. Which was, as you all know, economists use highly stylized models, make various kinds of assumptions. And my nagging doubt was would the work I did really be useful, would I make unrealistic assumptions. Could I really know what I was doing. And the other thing is I ultimately decide, yeah, I really do want to take care of patients. So I decided to combine the two fields. And you asked was that unusual. At the time, as far as I knew-- and this is still true-- at the time, there were only two people who were either in the process of getting or had gotten MDs and PhDs in economics. Both at the time were here. One of them was a faculty member at MIT who had been a Harvard undergrad, got an MD/PhD at Penn. The other was, I think, finishing up his combination of MD and PhD at MIT and Harvard Medical School. And they were fairly encouraging about getting the two degrees. Now, let me add. I was very concerned about a series of policy issues. People were worried at the time about un- insurance. And health care costs seem to be rising at an unsustainable rate. By the time I graduated college, health expenditures had reached 8% GDP after this period of continuous rise. Well, as you all know, we're at about 18% today. So I was correct that health expenditures would rise. I had a misconception about how high they could go. But I knew this was something I wanted to work on. And so that's how I ended up in the field. And I have to say that the curricular choices today are much greater. There are many more programs for people who have interests like mine. But one thing that any student should keep in mind is that it's not so much about what's the optimal program in general. It's what matches your interests and what will really excite you. And I was completely taken with the economic approach to modeling. And for most of my career, what I've basically done is apply economic tools to problems of health care and health policy. ROBERT J. So when you took your first academic role, strategically, what did you see this joint focus? How did you see this BLENDON: playing? Medical schools and economics departments were not instantly related, as I recall. And how did you think about the role you would play between two schools, two fields. Or did it just come naturally? ALAN M. Well, it came pretty naturally. I had to get my PhD at Harvard because I had taken enough courses that if I went GARBER: anywhere else, it would've taken at least an extra year.
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